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Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study

INTRODUCTION: Implementation of clinical practice guidelines (CPGs) to manage musculoskeletal conditions among physiotherapists appears suboptimal. Osteoarthritis is one of the most disabling conditions worldwide and several studies showed a lack of knowledge of and adherence to osteoarthritis CPGs...

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Autores principales: Battista, Simone, Salvioli, Stefano, Millotti, Serena, Testa, Marco, Dell’Isola, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067645/
https://www.ncbi.nlm.nih.gov/pubmed/33892692
http://dx.doi.org/10.1186/s12891-021-04250-4
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author Battista, Simone
Salvioli, Stefano
Millotti, Serena
Testa, Marco
Dell’Isola, Andrea
author_facet Battista, Simone
Salvioli, Stefano
Millotti, Serena
Testa, Marco
Dell’Isola, Andrea
author_sort Battista, Simone
collection PubMed
description INTRODUCTION: Implementation of clinical practice guidelines (CPGs) to manage musculoskeletal conditions among physiotherapists appears suboptimal. Osteoarthritis is one of the most disabling conditions worldwide and several studies showed a lack of knowledge of and adherence to osteoarthritis CPGs in physiotherapists’ clinical practice. However, those studies are not conclusive, as they examine the knowledge of and adherence to CPGs only in isolation, or only by focussing on a single treatment. Thus, analysis of the knowledge of and adherence to CPGs in the same sample would allow for a better understanding of the evidence-to-practice gap, which, if unaddressed, can lead to suboptimal care for these patients. This study aims at assessing Italian physiotherapists’ evidence-to-practice gap in osteoarthritis CPGs. METHODS: An online survey divided into two sections investigating knowledge of and adherence to CPGs was developed based on three high-quality, recent and relevant CPGs. In the first section, participants had to express their agreement with 24 CPG statements through a 1 (completely disagree) to 5 (completely agree) scale. We defined a ≥ 70% agreement with a statement as consensus. In the second section, participants were shown a clinical case, with different interventions to choose from. Participants were classified as ‘Delivering’ (all recommended interventions selected), ‘Partially Delivering’ (some recommended interventions missing) and ‘Non-Delivering’ (at least one non-recommended interventions selected) the recommended intervention, depending on chosen interventions. RESULTS: 822 physiotherapists (mean age (SD): 35.8 (13.3); female 47%) completed the survey between June and July 2020. In the first section, consensus was achieved for 13/24 statements. In the second section, 25% of the participants were classified as ‘Delivering’, 22% as ‘Partially Delivering’ and 53% as ‘Non-Delivering’. CONCLUSIONS: Our findings revealed an adequate level of knowledge of osteoarthritis CPGs regarding the importance of exercise and education. However, an adequate level of adherence has yet to be reached, since many physiotherapists did not advise weight reduction, but rest from physical activity, and often included secondary treatments (e.g. manual therapy) supported by low-level evidence. These results identify an evidence-to-practice gap, which may lead to non-evidence based practice behaviours for the management of patients with osteoarthritis.
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spelling pubmed-80676452021-04-26 Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study Battista, Simone Salvioli, Stefano Millotti, Serena Testa, Marco Dell’Isola, Andrea BMC Musculoskelet Disord Research Article INTRODUCTION: Implementation of clinical practice guidelines (CPGs) to manage musculoskeletal conditions among physiotherapists appears suboptimal. Osteoarthritis is one of the most disabling conditions worldwide and several studies showed a lack of knowledge of and adherence to osteoarthritis CPGs in physiotherapists’ clinical practice. However, those studies are not conclusive, as they examine the knowledge of and adherence to CPGs only in isolation, or only by focussing on a single treatment. Thus, analysis of the knowledge of and adherence to CPGs in the same sample would allow for a better understanding of the evidence-to-practice gap, which, if unaddressed, can lead to suboptimal care for these patients. This study aims at assessing Italian physiotherapists’ evidence-to-practice gap in osteoarthritis CPGs. METHODS: An online survey divided into two sections investigating knowledge of and adherence to CPGs was developed based on three high-quality, recent and relevant CPGs. In the first section, participants had to express their agreement with 24 CPG statements through a 1 (completely disagree) to 5 (completely agree) scale. We defined a ≥ 70% agreement with a statement as consensus. In the second section, participants were shown a clinical case, with different interventions to choose from. Participants were classified as ‘Delivering’ (all recommended interventions selected), ‘Partially Delivering’ (some recommended interventions missing) and ‘Non-Delivering’ (at least one non-recommended interventions selected) the recommended intervention, depending on chosen interventions. RESULTS: 822 physiotherapists (mean age (SD): 35.8 (13.3); female 47%) completed the survey between June and July 2020. In the first section, consensus was achieved for 13/24 statements. In the second section, 25% of the participants were classified as ‘Delivering’, 22% as ‘Partially Delivering’ and 53% as ‘Non-Delivering’. CONCLUSIONS: Our findings revealed an adequate level of knowledge of osteoarthritis CPGs regarding the importance of exercise and education. However, an adequate level of adherence has yet to be reached, since many physiotherapists did not advise weight reduction, but rest from physical activity, and often included secondary treatments (e.g. manual therapy) supported by low-level evidence. These results identify an evidence-to-practice gap, which may lead to non-evidence based practice behaviours for the management of patients with osteoarthritis. BioMed Central 2021-04-23 /pmc/articles/PMC8067645/ /pubmed/33892692 http://dx.doi.org/10.1186/s12891-021-04250-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Battista, Simone
Salvioli, Stefano
Millotti, Serena
Testa, Marco
Dell’Isola, Andrea
Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
title Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
title_full Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
title_fullStr Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
title_full_unstemmed Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
title_short Italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
title_sort italian physiotherapists’ knowledge of and adherence to osteoarthritis clinical practice guidelines: a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067645/
https://www.ncbi.nlm.nih.gov/pubmed/33892692
http://dx.doi.org/10.1186/s12891-021-04250-4
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